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Thursday, September 6, 2012

This past spring I read an interesting abstract authored
by Cynthia J. Larson, Aaron Freeberg and Wendolyn Slattery titled “The Effect
of Proper Cloth Saturation on Disinfection of High Touch Surfaces”. Although I
sadly didn’t get an opportunity to attend their abstract presentation during
this year’s APIC Conference in San Antonio, the abstract presents a
straightforward account of their study and the impact cloth saturation can have
on the effectiveness of cleaning practices.

As Nicole and I have lamented time and time again,
contact time is important when using disinfectants! If the contact time is not
complied with, it’s likely that disinfection is simply not being achieved.
Selecting a disinfectant with a rapid and realistic contact time will most
certainly make this an easier goal to achieve however, we will still need to
use or apply the disinfectant in such a way that its contact time is easily
complied with. Not surprisingly, the saturation level of the cloth or wipe used
to apply the disinfectant will play a major role in ensuring adequate coverage
of the surface. But, when was the last time you incorporated a discussion on
cloth saturation into your cleaning and disinfection training? I’ll admit, even
I’m guilty of glossing over that detail when I’m assisting with such training
sessions.

The Larson et al. study found that improving the
saturation of disinfectant on the cleaning cloths in conjunction with some
education on effective cleaning processes did improve environmental monitoring
scores by 24% initially and with continued feedback improved them by 55%
overall. But, what is the appropriate amount of saturation?? In my opinion, the
cloth should be wet with the solution, but not so wet that it is dripping
everywhere. It should be sufficiently saturated to provide consistent and even
coverage of the surface but not pose any risk to the user because it’s
“sloshing” everywhere. The study found that utilizing a cloth and bucket
process provided superior saturation when compared with their prior method of
pouring the disinfectant solution onto the cloth prior to wiping the surface.
We too have found this in practice and will often recommend this application
method when feasible.

What about pre-saturated disinfectant wipes? How do we
ensure they are sufficiently saturated? More correctly the question should be:
How do we ensure that the disinfectant wipes stay sufficiently saturated?
Disinfectant wipe manufacturers have determined exactly how much solution is
required to fully saturate their wipe substrate and will manufacture the
product with this in mind. With that being said, end-users need to ensure that
the wipes remain wet by keeping the canister closed when not in-use. If the
canister is left open, the first wipe or two may slowly dry out in which case
they should be discarded in favour of a fully saturated wipe when the cleaning
and disinfection task is at hand. Likewise, common sense should play into the
equation when using disinfectant wipes to clean and disinfect larger
surfaces.A single 6”x7” disinfectant
wipe is unlikely to distribute enough solution onto a 4’x8’ table for
instance.In other words, multiple wipes
may be required to complete some tasks.

To summarize, a nearly dry cloth or wipe is unlikely to
help us effectively clean and disinfect high touch surfaces.End-users should ensure that their cloth is
sufficiently saturated, yet not dripping wet, when cleaning and disinfection in
order to provide them with the most likely chance for success.

So, are you going to include mention of cloth saturation
in your next environmental cleaning training session?